Objective: To investigate HIV-1 subtypes and drug resistance in HIV/AIDS patients who failed in antiretroviral therapy in Jinhua City, Zhejiang Province, so as to provide the basis for improving antiretroviral therapy strategy. Methods: Totally 128 plasma samples of HIV/AIDS patients who failed in antiretroviral therapy (treatment for more than 6 months and viral load ≥1 000 copies/mL) from January 1 to November 30, 2023 were collected. After nucleic acid extraction and amplification, the sequences of HIV-1 pol genes were determined using first generation sequencing method, then submitted to HIV resistance database of Stanford University in the United States, and the subtypes, drug resistance mutations and drug resistance status of HIV-1 were analyzed. Results: A total of 118 sequences of HIV/AIDS patients were obtained, including 94 males and 24 females (male to female ratio, 3.9︰1). There were 53 cases aged between 40 to 59 years, accounting for 44.92%. The main infection routes was heterosexual contact, with 92 cases accounting for 77.97%. The main HIV-1 gene subtypes were CRF07_BC and CRF01_AE, with 45 and 39 cases accounting for 38.14% and 33.05%, respectively. There were 75 cases found to have drug-resistant site mutations, with a mutation rate of 63.56%. The most common mutation sites were M184 and K103, with mutation rates of 29.66% and 28.81%, respectively. There were 58 cases with resistance to more than one drug, with a rate of 49.15%. The rates of resistance to non-nucleoside reverse transcriptase inhibitors (NNRTI), nucleotide reverse transcriptase inhibitors (NRTI) and protease inhibitors (PI) were 50.00%, 33.90% and 4.24%, respectively. Conclusion The HIV-1 gene subtypes of HIV/AIDS patients who failed in antiretroviral therapy in Jinhua City are mainly CRF07_BC and CRF01_AE, which are mainly resistant to NNRTI and NRTI.

Objective To sunmarize the clinical experience of emergency laparoscopic choledocholithotomy plus T-tube drainage for acute calculous cholangitis.Methods We retrospectively analyzed the clinical data of 98 cases with acute calculous cholangitis undergoing emergency laparoscopic choledocholithotomy between Mar 2007 to Jul 2011 at our hospital.Results In this study,93 cases with definite diagnosis of acute calculous cholangitis underwent at their acute stage totally laparoscopic choledocholithotomy and T-tube drainage,2 cases received laparoscopic transeystic common bile duct exploration and 3 cases were treated with primary closure of the common bile duct following laparoscopic common bile duct exploration and intra-bile duct stent.All procedures were successful without conversion to open surgery.The average of the operative time and the hospital stay was 96 minutes and 12 days respectively.The major complications included residual stones in 8 cases,bile leakage in 4 cases and intraperitoneal bleeding in I case.All were cured by conservative therapy.Conclusions For most patients of acute calculous cholangitis,emergency T-tube drainage after laparoscopic chuledocholithotomy is safe and effective.

SUMMARY To summarize the experience of managing substernal goiter by totally endoscopic procedure and evaluate the curative effect , we analysed eight patients diagnosed as substernal goiter type Ⅰ and treated with totally endoscopic technique via central routing approach during March 2011 to June 2013 in Beijing Shijitan Hospital retrospectively .The feasibility , safety and curative effect of this surgical tech-nique were estimated .All the cases were successfully operated with the totally endoscopic procedure , and the pathological result showed that 6 were goiter and the other 2 were minimal papillary carcinoma .None of the patients suffered from any complication , and the median follow up time was 6 months ( 1 -28 months) .The totally endoscopic technique is a feasible , safe and cosmic one for managing substernal goiter type Ⅰ.

Patrolling monocyte (PMo) is a subset of monocytes.Its main function is patrolling vascular endothelium and removing cellular debris from the microvasculature.Studies have revealed that PMo can inhibit the growth of tumor cells,recruiting NK cells to kill tumor cells.PMo can prevent tumor cells metastasis to the lung,which plays a role of immunosurveillance.PMo may be a target for cancer immunotherapy.

ObjectiveTo investigate the changes of non-linear dynamics characteristics of EEG of the patients with menopause depression under eyes closed state.MethodsEEG were recorded in 18 patients with menopause depression and 18 healthy volunteers under eyes closed state. Approximate entropy (ApEn) was calculated for all subjects.ResultsApEn of the menopause depression group at eyes closed state increased significantly compared with that of the healthy control group.ConclusionDynamic non-linear analysis is more appropriate for the study of mental functions changes of menopause depression.

Adolescent ; Child ; Diagnosis, Differential ; Dystonic Disorders ; diagnosis ; drug therapy ; physiopathology ; Female ; Humans ; Male

Objective To evaluate the effectiveness and safety of open tension-free hernioplasty and two kind of laparoscopic hernia repair for the treatment of primary unilateral inguinal hernia. Methods Patients suffering from primary unilateral inguinal hernia were randomly divided into 3 groups to undergoopen operation with mesh-plug and patch or transabdominal preperitoneal hernioplasty (TAPP) or totally extraperitoneal hernioplasty (ZEP). Results From February 2006 to February 2009, a total of 164patients were divided into 3 groups, with 62 undergoing open tension-free mesh-plug hernia repair, 50receiving TAPP and 52 receiving TEP. Postoperative patients were then followed up for a period of(16±8)months. The average operating time for the patients in the open mesh repair group was significantly shorter compared to the other two groups (P＜0.01 ). The cost in the open mesh repair group was also significantly lower than the other two groups (P＜0.01). The pain scores in open mesh group were significantly higher than those in the other two groups (P＜0.01). The hospital stay and the recovery time were both significantly longer in the open mesh repair group (P＜0.01) compared to the other two groups. No major complications and recurrence was found in neither groups. Conclusions Open tension-free mesh-plug hernia repair, TAPP and TEP are all safe and effective for the treatment for patients with primary unilateral inguinal hernia. TAPP and TEP are superior to open tension-free mesh-plug hernia repair as these two procedures involve less postoperative pain and fast recovery.

Objective To explore the clinical effect and safety of patients with advanced breast cancer with capecitabine and gemcitabine combined with capecitabine treatment scheme. Methods 82 cases of patients with advanced breast cancer received treatment in our hospital from February 2014 to March 2016 were randomly selected and were randomly divided into control group and study group, 41 cases in each group.The control group using capecitabine monotherapy, the study group used capecitabine combined with docetaxel treatment. The therapeutic effects, safety and adverse reactions of the two groups were compared. Results The effective rate of treatment in the study group was 56.48 %, significantly better than that in the control group(34.28 %), the difference was statistically significant, The incidence of complications after treatment in the control group was 40.22 %, significantly higher than that in the study group (18.04 %), and the difference was statistically significant (P<0.05). Conclusion Capecitabine combined with docetaxel in the treatment of advanced breast cancer has good effect and low incidence of adverse reactions. It is worthy of recommendation and Application.

Objective To investigate the clinical effect of renal transplantation in elderly patients.Methods Retrospective analysis was held on 49 elderly patients aged over 65 years who underwent renal transplantation,and compared with 87 patients under the age of 50 years who underwent the renal transplantation during the same time.Results The survival rate at one year was 85.7% in elderly patients,and 93.1% in the non-elderly patients(P＜0.05).The graft survival rate at one year was 89.8% in elderly patients,and 90.8% in the non-elderly patients,but no significant difference was found between the two groups.The rate of acute rejection response was 10.2% in elderly patients,significantly lower than that in non-elderly patients(28.7%).The rate of complication of cardio-cerebrovascular diseases in elderly patients(51.1%)were higher than those in non-elderly patients(19.5%,P＜0.05).The dosages of immunosuppressive agent cyclosporine in 3 months,3-6 months and 6-12 months were(3.6?1.1),(3.1?0.9)mg?kg~(-1)?d~(-1) and (2.9?0.7) mg?kg~(-1)?d~(-1)in elderly group,significantly lower than those[(5.4?1.4),(4.6?1.3)mg?kg~(-1)?d~(-1)and(4.1?1.0)mg?kg~(-1)?d~(-1)]in non-elderly group(P＜0.05).Conclusions Renal transplantation in elderly patients is effective and reliable.

BACKGROUND:During the healing of fractures, removal of sciatic nerve can result in insufficient mechanical rigidity of newborn woven bone. However, there are less reports concerning the denervation effects during distraction osteogenesis. OBJECTIVE:To observe the effect of removal of the sciatic nerve on bone regeneration and the expression of Runt-related transcription factor 2 (Runx2) protein during distraction osteogenesis in a rabbit model. METHODS:Twenty-four adult male New Zealand rabbits were selected and underwent left tibial osteodistraction to construct animal models of distraction osteogenesis. Before distraction, the animals were randomly divided into group R (resecting the left sciatic nerve) and group I (intact left sciatic nerve). Six weeks after completion of distraction, the animals were kil ed and the lengthened tibias were harvested for radiography, three-dimensional CT reconstruction, histological evaluation, connectivity density (Conn.D) evaluation. RESULTS AND CONCLUSION:New regenerated bone was present and Runx2 protein was expressed in the distraction gaps of al animals at the end of the study, as revealed by radiography, three-dimensional CT reconstruction, and histological observation. However, less new bone formation and a lower degree of mineralization and expression of Runx2 protein were observed in group R compared with group I. The results suggest that the denervation appears to have an inhibitory effect on bone formation and the expression of Runx2 protein during distraction osteogenesis.